Behavioral Weight Loss Program for Children and Their Parents

A weight reduction program for overweight children and their parents was developed. The program can be supplemented and/or integrated with parent training sessions on child management skills. In a random assignment study with a wait-list control group, families were assigned to one of three groups: a control group that received no intervention, a treatment group that received only the weight reduction intervention, and a treatment group that received the weight reduction intervention and the parent training sessions. At the end of the nine-week intervention period, children assigned to the two treatment groups had lost significantly more weight than had children in the control group. During the year-long follow-up period, children whose parents received the parent training sessions were more likely to maintain their improved weight status than were children whose parents did not receive this training.

DESCRIPTION OF PROGRAM

Target population: Overweight children and their parents

This program focuses on weight reduction for overweight children and their parents. Through nine weekly sessions (each 90 minutes in length), children and their parents attend the program together, though parents take part in activities separate from their children during each session. Sessions are led in a lecture-discussion format. Sessions include individualized programming and an opportunity for children and parents to share information and experiences with one another. Program participants are encouraged to monitor food and caloric intake, energy expenditure, and adherence to recommended changes in weight-related habits. Responsibility for monitoring is shared between parents and children.

The weight reduction program can be supplemented with a parent training program. This program consists of two hour-long sessions on child management skills and is administered by an advanced graduate student in clinical psychology prior to the commencement of the weight reduction program. Two other graduate students assist in leading sessions and making phone calls between sessions to assist parents with homework assignments, provide motivational input, and further individualize treatment procedures. Child sessions are led by two undergraduate students who are trained and supervised by the parent session leader. Session content is based upon Gerald R. Patterson’s book Living with Children. Lessons learned during this two-hour supplement can be integrated into the weight reduction program’s parent sessions.

Evaluated population: A total of33 overweight children and their parents were recruited for participation in the study. Children were required to be between the ages of 8 and 12 and had to be at least 20 percent overweight to participate in the study.

Approach: Families were randomly assigned to one of three groups: a weight reduction only treatment group (N=12), a weight reduction plus parent training treatment group (N=12), and a wait-list control group (N=9). Children assigned to the control group did not take part in a weight loss intervention.

All children and their parents were weighed and surveyed at the beginning and end of the nine week intervention. Following the conclusion of the intervention period, all treatment children and their parents came in for weigh-ins and problem-solving discussions at 1, 2, 4, 6, 9, and 12 months. During the follow-up period, families assigned to the wait-list control group were given the opportunity to take part in the weight reduction program.

Results: At the end of the nine-week intervention period, children in the treatment groups had lost significantly more weight than had children in the control group. The amount of weight lost by children in the weight reduction plus parent training group did not differ significantly from the amount of weight lost by children in the weight reduction only group. However, on average, children in the weight reduction only group were less overweight than children in the weight reduction plus parent training group (as measured by percent overweight) at the end of the intervention period.

Among parents who were overweight at the commencement of the intervention, parents in the treatment groups lost more weight than parents in the control group at the end of the nine-week intervention period. There was no significant difference in amount of weight lost between parents in the weight reduction plus parent training group and parents in the weight reduction only group.

Treatment children improved their parent-reported eating habits to a greater extent than did control children over the course of the intervention period. Eating habits among children in the weight reduction plus parent training group did not differ significantly from eating habits among children in the weight reduction only group. Parents in the weight reduction plus parent training group had significantly greater self-reported knowledge of child management than did parents in the weight reduction only group and the control group at the end of the intervention period.

There is no control group for the follow-up analyses, as wait-list controls were offered the treatment. During the one-year follow-up period, children in the weight reduction only condition were significantly less likely than children in the weight reduction plus parent training condition to decrease their percent overweight. Children in the weight reduction plus parent training group had similar parent-reported eating habits to children in the weight reduction only group during the follow-up period.